ABSTRACT
Although a major portion of terminal cancer patients have appealed pain, the management of their pains is not easy. We managed two terminal cancer patients. One subject was a 86-year-old female who, after pronounced lung cancer, suffered from shoulder pain. The other was a 28-year-old female who, after being subject to pronounced acute lymphocytic leukemia, suffered from hip joint and thigh pain. In our practice, their pain, which had not been controlled by various other sophisticated management strategies, was effectively alleviated by a continuous intravenous infusion of ketamine, a N-methyl-D-aspartic acid receptor antagonist. The initial dose was administered intramuscularly by injecting 10 mg. of ketamine into the patients and then an intravenous infusion was administered at the rate of 0.06 mg/kg/hr. After the continuous infusion of ketamine was initiated, the VAS decreased, respectively, from 9 and 10 to 4 and 3, without considerable side effects. In conclusion, intravenous infusion at the level of sub-anesthetic dose of ketamine is a good management to control totally bed-conditioned and intactable cancer pain.